A 70‐year‐old man with a history of a previous myocardial infarction was admitted to our department because of clinical stroke. Electrocardiography revealed sinus rhythm and ST segment elevation in the anterior leads, which was unchanged from an ECG obtained eighth years previously. Multidetector computed tomographic cardiac scan (MDCT) showed a calcified aneurysm in association with a large mural thrombus in the apical wall of the left ventricle (panel A). Most cardiac aneurysms develop after myocardial infarction. Calcification in the aneurysmal wall is seen rarely. Left ventricular thrombus formation may occur in the early course after acute myocardial infarction. Delayed thrombus formation is frequently associated with wall motion deterioration.
(A) Multidetector computed tomography (MDCT) without contrast showing the calcified aneurysm (arrow) in the apical wall of the left ventricle. (B) MCDT with contrast showing the previously calcified aneurysm and a large left ventricular mural thrombus (arrow).